Estudio de la efectividad de la intervención psicológica en pacientes con cáncer de mama localizado / Effectiveness study of psychological intervention in patients with localized breast cancer

OBJETIVO: valorar la efectividad de la intervención psicológica individual sobre ansiedad, depresión y las estrategias de afrontamiento en tres grupos: Grupo 1 (G1) que utiliza la Terapia Cognitivo Conductual (TCC); Grupo 2 (G2) basado en counselling y psicoeducación; y el Grupo Control (GC) que no realiza intervención psicológica. MÉTODO: estudio cuasi experimental con una muestra de 180 pacientes y 51,9 años de edad media. Los instrumentos de evaluación fueron el MINI-MAC y el HADS; se administraron después de la operación quirúrgica a G1 (n= 50) y G2 (n=98), y al finalizar el tratamiento quimioterápico a G1, G2 y GC (n=32). RESULTADOS: después de 7 meses de intervención psicológica, G1 redujo significativamente las medias de ansiedad, depresión, preocupación ansiosa y desesperanza; en G2 disminuyeron los niveles de ansiedad, depresión; y se mantuvo el espíritu de lucha al mismo nivel. El GC demostró niveles de depresión, ansiedad y preocupación ansiosa mayores que G1 y G2. CONCLUSIÓN: la intervención psicológica (independientemente del tipo de terapia) ayuda a reducir las medias de depresión y ansiedad e incrementar las estrategias de afrontamiento adecuadas como el espíritu de lucha. La TCC es más efectiva en la reducción de sintomatología clínica depresiva y ansiosa. El counselling y la psicoeducación contribuyen a mantener y mejorar las medias de ansiedad, depresión en parámetros no clínicos y fomenta el espíritu de lucha en mujeres que no poseían inicialmente sintomatología depresiva o ansiosa grave

OBJECTIVE: analysing the effectiveness of individual psychological intervention focusing on coping skills, anxiety and depression in 3 groups: Group 1 (G1) which used Cognitive Behavioral Therapy (CBT); Group 2 (G2) based in counselling and psychoeducation therapy; and the Control Group (CG) without psychological intervention. METHOD: quasi-experimental longitudinal study with a sample of 180 patients with a mean of 51,9 years of age. The instruments used were the MINI-MAC and the HADS; they were administered to G1 (n= 50) and G2 (n=98) after surgery; and at the end of chemotherapy to G1, G2 and CG (n=32). RESULTS: after 7 months of intervention psychological, the levels of anxiety, depression, anxious preoccupation and hopelessness reduced in G1. The levels of depression and anxiety dropped in G2 as they maintained the fighting spirit. GC showed higher levels of depression, anxiety, anxious preoccupations than G1 and G2. CONCLUSIONS: psychological intervention (regardless the type of therapy) leads to reduce depressive and anxious symptomatology and increased more effective coping strategies. CBT is the most effective therapy for reducing clinical depression and symptoms of anxiety. Counselling and psychoeducational therapy lead to improvement and ensure the levels of anxiety and depression remain within manageable parameters, promoting the same fighting spirit by women without clinical depressive or anxious symptoms

Effectiveness of therapy group in women with localized breast cancer.

BACKGROUND/OBJECTIVE: Breast cancer causes high levels of anxiety and depression, deteriorating quality of life of patients. Several studies have found that group therapy reduces depression and anxiety also improves the quality of life. The aim of this study is to analyze group therapy effectiveness in emotional state and quality of life in women with breast cancer after finalized medical treatments. METHOD: Participants in this study were 100 adult women diagnosed of breast cancer non-mestastasic and were divided into two types of intervention groups (Self-esteem-Social Skills and Cognitive-Behavioral Therapy). Evaluation instruments were questionnaire Functional Assessment of Breast-cancer Therapy (FACT-B) and Hospital Anxiety and Depression Scale (HADS). RESULTS: A statistically significant effect of group therapy in reducing anxiety and depression were observed. Quality of life and emotional well-being significantly improved. These effects remain three months after intervention. CONCLUSIONS: The results show that the psychological intervention group is efficient to improve emotional state and quality of life of women with breast cancer.

ANTECEDENTES/OBJETIVO: El cáncer de mama provoca niveles altos de ansiedad y depresión, empeorando la calidad de vida (CV) de las pacientes. En numerosos estudios se ha visto que la terapia grupal reduce la depresión y ansiedad además de mejorar la CV. El objetivo de este estudio es analizar la efectividad de la intervención de la terapia grupal en el estado emocional y la CV de mujeres con cáncer de mama localizado al finalizar los tratamientos médicos. MÉTODO: La muestra consta de 100 mujeres diagnosticadas de cáncer de mama no metastásico, divididas en dos tipos de grupos de intervención (Autoestima-habilidades sociales y Terapia cognitivo-conductual). Los instrumentos de evaluación fueron el cuestionario Functional Assessment of Cancer Therapy-Breast y la Escala Hospitalaria de Ansiedad y Depresión (HADS). RESULTADOS: Se observa un efecto estadísticamente significativo de la terapia grupal en la reducción de la ansiedad y la depresión. Las medias de la CV y del bienestar emocional mejoran de manera significativa. Estos efectos se mantienen tres meses después de la intervención. CONCLUSIONES: Los resultados muestran la efectividad de los grupos de terapia para mujeres con cáncer de mama mejorando el estado emocional y la CV.

Effectiveness of therapy group in women with localized breast cancer / Efectividad de la terapia grupal en mujeres con cáncer de mama localizado

Background/Objective: Breast cancer causes high levels of anxiety and depression, deteriorating quality of life of patients. Several studies have found that group therapy reduces depression and anxiety also improves the quality of life. The aim of this study is to analyze group therapy effectiveness in emotional state and quality of life in women with breast cancer after finalized medical treatments. Method: Participants in this study were 100 adult women diagnosed of breast cancer non-mestastasic and were divided into two types of intervention groups (Self-esteem-Social Skills and Cognitive-Behavioral Therapy). Evaluation instruments were questionnaire Functional Assessment of Breast-cancer Therapy (FACT-B) and Hospital Anxiety and Depression Scale (HADS). Results: A statistically significant effect of group therapy in reducing anxiety and depression were observed. Quality of life and emotional well-being significantly improved. These effects remain three months after intervention. Conclusions: The results show that the psychological intervention group is efficient to improve emotional state and quality of life of women with breast cancer

Antecedentes/Objetivo: El cáncer de mama provoca niveles altos de ansiedad y depresión, empeorando la calidad de vida (CV) de las pacientes. En numerosos estudios se ha visto que la terapia grupal reduce la depresión y ansiedad además de mejorar la CV. El objetivo de este estudio es analizar la efectividad de la intervención de la terapia grupal en el estado emocional y la CV de mujeres con cáncer de mama localizado al finalizar los tratamientos médicos. Método: La muestra consta de 100 mujeres diagnosticadas de cáncer de mama no metastásico, divididas en dos tipos de grupos de intervención (Autoestima-habilidades sociales y Terapia cognitivo-conductual). Los instrumentos de evaluación fueron el cuestionario Functional Assessment of Cancer Therapy-Breast y la Escala Hospitalaria de Ansiedad y Depresión (HADS). Resultados: Se observa un efecto estadísticamente significativo de la terapia grupal en la reducción de la ansiedad y la depresión. Las medias de la CV y del bienestar emocional mejoran de manera significativa. Estos efectos se mantienen tres meses después de la intervención. Conclusiones: Los resultados muestran la efectividad de los grupos de terapia para mujeres con cáncer de mama mejorando el estado emocional y la CV

Cardio-Onco-Hematología en la práctica clínica. Documento de consenso y recomendaciones / Cardio-Onco-Hematology in clinical practice. Position paper and recommendations

Los avances en la detección precoz y el tratamiento del cáncer han reducido de manera significativa la mortalidad de los pacientes. Sin embargo, mejorar el pronóstico no es solo curar el tumor, sino prevenir, diagnosticar y tratar eficazmente las complicaciones derivadas de las terapias onco-hematológicas. La toxicidad cardiovascular es un problema ampliamente reconocido con múltiples esquemas terapéuticos; sin embargo, la evidencia científica en el manejo de las complicaciones cardiovasculares de pacientes onco-hematológicos es escasa, pues sistemáticamente se ha excluido de los ensayos clínicos a estos enfermos y las recomendaciones actuales están basadas en consensos de expertos. Es imprescindible crear equipos multidisciplinarios locales para optimizar los resultados en salud de los supervivientes al cáncer. Una preocupación excesiva por la aparición de toxicidad cardiovascular puede impedir terapias potencialmente curativas, mientras que la subestimación de este riesgo compromete el pronóstico vital a largo plazo. El objetivo de este documento, elaborado en colaboración con la Sociedad Española de Cardiología, la Sociedad Española de Oncología Médica, la Sociedad Española de Oncología Radioterápica y la Sociedad Española de Hematología, es actualizar los conocimientos aplicables a la práctica clínica diaria de la cardio-onco-hematología y promover el desarrollo de equipos multidisciplinarios locales que mejoren la salud cardiovascular de los pacientes con cáncer (AU)

Improvements in early detection and treatment have markedly reduced cancer-related mortality. However survival not only depends on effectively cure cancer, but prevention, diagnosis and treatment of cancer-related complications is also needed. Cardiovascular toxicity is a widespread problem across many classes of therapeutic schemes, however scientific evidence in the management of cardiovascular complications of onco-hematological patients is scarce, as these patients have been systematically excluded from clinical trials and current recommendations are based on expert consensus. Multidisciplinary teams are mandatory to decrease morbidity and mortality from both cardiotoxicity and cancer itself. An excessive concern for the occurrence of cardiovascular toxicity, can avoid potentially curative therapies, while underestimating this risk, increases long-term mortality of cancer survivors. The objective of this consensus document, developed in collaboration of the Spanish Society of Cardiology, the Spanish Society of Medical Oncology, the Spanish Society of Radiation Oncology and the Spanish Society of Hematology, is to update the necessary concepts and expertise on cardio-onco-hematology that enable its application in daily clinical practice and to promote the development of local multidisciplinary teams, to improve the cardiovascular health of patients with cancer (AU)

Cardio-Onco-Hematology in Clinical Practice. Position Paper and Recommendations.

Improvements in early detection and treatment have markedly reduced cancer-related mortality. However survival not only depends on effectively cure cancer, but prevention, diagnosis and treatment of cancer-related complications is also needed. Cardiovascular toxicity is a widespread problem across many classes of therapeutic schemes, however scientific evidence in the management of cardiovascular complications of onco-hematological patients is scarce, as these patients have been systematically excluded from clinical trials and current recommendations are based on expert consensus. Multidisciplinary teams are mandatory to decrease morbidity and mortality from both cardiotoxicity and cancer itself. An excessive concern for the occurrence of cardiovascular toxicity, can avoid potentially curative therapies, while underestimating this risk, increases long-term mortality of cancer survivors. The objective of this consensus document, developed in collaboration of the Spanish Society of Cardiology, the Spanish Society of Medical Oncology, the Spanish Society of Radiation Oncology and the Spanish Society of Hematology, is to update the necessary concepts and expertise on cardio-onco-hematology that enable its application in daily clinical practice and to promote the development of local multidisciplinary teams, to improve the cardiovascular health of patients with cancer.

Low penetrance alleles as risk modifiers in familial and sporadic breast cancer.

The aim of the study is to investigate the relevance of rs1056663 and rs2708861 HUS1 polymorphisms, and rs104548, rs2981582 and rs2910164 polymorphisms of CASP8, FGFR2 and micro RNA 146A genes, respectively, as risk modifiers in hereditary breast or ovarian cancer (BC/OC) and risk factors in sporadic BC. We performed a case-control study in 189 healthy controls (CG) and 538 BC/OC cases, 340 with familial history of BC/OC (130 carriers of BRCA1/2 mutations and 210 non-carriers) and 198 sporadic BC/OC. The polymorphisms were assessed by real-time PCR using primers and fluorescent-labelled hybridization probes. We found statistically significant differences between familial BC/OC and CG for rs1056663 and rs2708861 HSU1 polymorphisms and rs2981582 FGFR2 polymorphism, particularly in non-carriers of BRCA1/2 mutations. In this group we found statistical differences for rs1056663 HSU1 and rs2981582 FGFR2 polymorphisms (p-trend < 0.006). The logistic regression confirmed that rs2981582 FGFR2 polymorphism (OR = 2.09; 95 % CI 1.35, 3.20) and the interaction between rs1056663 and rs2708861 HUS1 polymorphisms increased the risk of cancer (OR = 1.87; 95 % CI 1.19, 2.92). Furthermore, we found that the presence of rs1056663 and rs2708861 HUS1 polymorphisms is associated with early age of presentation of BC (p = 0.015) in the group of non-carriers of BRCA1/2 mutations. In addition, no association of the polymorphisms studied in sporadic BC was observed. In conclusion, the HUS1 and FGFR2 polymorphisms act as risk BC modifiers in familial BC/OC, particularly in the group of non-carriers of BRCA1/2 mutations.